ANCC PMHNP Practice Exam 2026
Practice Questions, Correct ANSWERs & Rationales — 2027 Q&A
QUESTIONS 1–25: ASSESSMENT AND DIAGNOSIS
Question 1
A 29-year-old patient reports depressed mood, loss of interest, fatigue, insomnia, feelings of
worthlessness, and difficulty concentrating for 3 weeks. Symptoms cause significant
occupational impairment. There is no history of mania or hypomania. Which diagnosis is most
appropriate?
A. Persistent depressive disorder
B. Major depressive disorder
C. Adjustment disorder
D. Cyclothymic disorder
Correct ANSWER: B. Major depressive disorder
Rationale: Major depressive disorder requires a depressive episode lasting at least 2 weeks with
sufficient symptoms to cause clinically significant distress or impairment. The presentation
meets these criteria.
Question 2
A patient has experienced excessive anxiety and worry about multiple areas of life nearly every
day for 8 months. The patient reports restlessness, fatigue, muscle tension, and difficulty
controlling the worry. Which diagnosis is most likely?
,A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Obsessive-compulsive disorder
Correct ANSWER: B. Generalized anxiety disorder
Rationale: Generalized anxiety disorder is characterized by excessive, difficult-to-control worry
about multiple domains for at least 6 months, accompanied by associated physical or cognitive
symptoms.
Question 3
A patient suddenly develops intense fear, palpitations, sweating, trembling, chest discomfort,
and fear of dying. The symptoms peak within several minutes. What is the most appropriate
term for this episode?
A. Manic episode
B. Panic attack
C. Dissociative episode
D. Psychotic episode
Correct ANSWER: B. Panic attack
Rationale: A panic attack is an abrupt surge of intense fear or discomfort that reaches a peak
rapidly and includes multiple autonomic and cognitive symptoms.
Question 4
,A patient reports recurrent intrusive thoughts about contamination and performs prolonged
handwashing rituals to reduce anxiety. Which disorder is most consistent with this
presentation?
A. Obsessive-compulsive disorder
B. Illness anxiety disorder
C. Generalized anxiety disorder
D. Delusional disorder
Correct ANSWER: A. Obsessive-compulsive disorder
Rationale: Obsessions are recurrent intrusive thoughts, while compulsions are repetitive
behaviors or mental acts performed to reduce distress or prevent a feared event.
Question 5
A patient experiences recurrent unexpected panic attacks followed by persistent concern about
having another attack and avoidance of situations where help may be unavailable. Which
diagnosis is most likely?
A. Agoraphobia only
B. Panic disorder
C. Social anxiety disorder
D. Specific phobia
Correct ANSWER: B. Panic disorder
, Rationale: Panic disorder involves recurrent unexpected panic attacks followed by persistent
concern or maladaptive behavioral changes related to the attacks.
Question 6
Which finding most strongly supports a diagnosis of bipolar I disorder?
A. Recurrent depressive episodes
B. A history of hypomania
C. At least one manic episode
D. Chronic irritability
Correct ANSWER: C. At least one manic episode
Rationale: Bipolar I disorder requires at least one manic episode. Depressive episodes
commonly occur but are not required for the diagnosis.
Question 7
A patient has elevated mood, decreased need for sleep, pressured speech, grandiosity, and
excessive spending for 10 days. Symptoms cause marked impairment and require
hospitalization. Which episode is present?
A. Hypomanic episode
B. Manic episode
C. Major depressive episode
D. Cyclothymic episode
Practice Questions, Correct ANSWERs & Rationales — 2027 Q&A
QUESTIONS 1–25: ASSESSMENT AND DIAGNOSIS
Question 1
A 29-year-old patient reports depressed mood, loss of interest, fatigue, insomnia, feelings of
worthlessness, and difficulty concentrating for 3 weeks. Symptoms cause significant
occupational impairment. There is no history of mania or hypomania. Which diagnosis is most
appropriate?
A. Persistent depressive disorder
B. Major depressive disorder
C. Adjustment disorder
D. Cyclothymic disorder
Correct ANSWER: B. Major depressive disorder
Rationale: Major depressive disorder requires a depressive episode lasting at least 2 weeks with
sufficient symptoms to cause clinically significant distress or impairment. The presentation
meets these criteria.
Question 2
A patient has experienced excessive anxiety and worry about multiple areas of life nearly every
day for 8 months. The patient reports restlessness, fatigue, muscle tension, and difficulty
controlling the worry. Which diagnosis is most likely?
,A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Obsessive-compulsive disorder
Correct ANSWER: B. Generalized anxiety disorder
Rationale: Generalized anxiety disorder is characterized by excessive, difficult-to-control worry
about multiple domains for at least 6 months, accompanied by associated physical or cognitive
symptoms.
Question 3
A patient suddenly develops intense fear, palpitations, sweating, trembling, chest discomfort,
and fear of dying. The symptoms peak within several minutes. What is the most appropriate
term for this episode?
A. Manic episode
B. Panic attack
C. Dissociative episode
D. Psychotic episode
Correct ANSWER: B. Panic attack
Rationale: A panic attack is an abrupt surge of intense fear or discomfort that reaches a peak
rapidly and includes multiple autonomic and cognitive symptoms.
Question 4
,A patient reports recurrent intrusive thoughts about contamination and performs prolonged
handwashing rituals to reduce anxiety. Which disorder is most consistent with this
presentation?
A. Obsessive-compulsive disorder
B. Illness anxiety disorder
C. Generalized anxiety disorder
D. Delusional disorder
Correct ANSWER: A. Obsessive-compulsive disorder
Rationale: Obsessions are recurrent intrusive thoughts, while compulsions are repetitive
behaviors or mental acts performed to reduce distress or prevent a feared event.
Question 5
A patient experiences recurrent unexpected panic attacks followed by persistent concern about
having another attack and avoidance of situations where help may be unavailable. Which
diagnosis is most likely?
A. Agoraphobia only
B. Panic disorder
C. Social anxiety disorder
D. Specific phobia
Correct ANSWER: B. Panic disorder
, Rationale: Panic disorder involves recurrent unexpected panic attacks followed by persistent
concern or maladaptive behavioral changes related to the attacks.
Question 6
Which finding most strongly supports a diagnosis of bipolar I disorder?
A. Recurrent depressive episodes
B. A history of hypomania
C. At least one manic episode
D. Chronic irritability
Correct ANSWER: C. At least one manic episode
Rationale: Bipolar I disorder requires at least one manic episode. Depressive episodes
commonly occur but are not required for the diagnosis.
Question 7
A patient has elevated mood, decreased need for sleep, pressured speech, grandiosity, and
excessive spending for 10 days. Symptoms cause marked impairment and require
hospitalization. Which episode is present?
A. Hypomanic episode
B. Manic episode
C. Major depressive episode
D. Cyclothymic episode
